Inflammation‐driven variability in drug metabolism: Insights from voriconazole treatment of HSCT recipients

British Journal of Clinical Pharmacology 2026 Open access

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Authors: Sylvia D. Klomp, Martijn L. Manson, Henk‐Jan Guchelaar, Stefan Böhringer, Esther H.M. van Egmond, Peter A. von dem Borne, Jesse J. Swen
DOI: 10.1002/bcp.70501
Cited by: 2
References: 58

Abstract

AIMS: Voriconazole is commonly used to prevent fungal infections after haematopoietic stem cell transplantation (HSCT). Although its metabolism is influenced by CYP2C19 genetics and inflammation, their combined effect is rarely considered in clinical practice, and integrated analyses remain limited. METHODS: We retrospectively analysed how inflammation and CYP2C19-predicted drug-metaboliser phenotypes affect voriconazole exposure and therapeutic range attainment in 126 HSCT patients. C-reactive protein (CRP) ≥ 10 mg/L defined inflammation. A linear mixed model (LMM) assessed associations between dose-corrected voriconazole concentrations, inflammation and CYP2C19-predicted drug-metaboliser phenotype. RESULTS: Dose-corrected voriconazole trough concentrations were associated with CYP2C19-predicted drug-metaboliser phenotype (LMM p =

Fields of Study & Subjects

Antifungal resistance and susceptibility Neutrophil Myeloperoxidase and Oxidative Mechanisms Ocular Infections and Treatments

Publication details

Journal / source
British Journal of Clinical Pharmacology
Publisher
Wiley
Volume
92
Issue
7
Pages
2250–2259
Publication date
1 March 2026
Language
EN